It is important to determine whether the tool(s) you have chosen are appropriate for the context of your CE process. In some cases they might need to be customized or adapted. Are there any barriers that might prevent the stakeholders you are trying to reach from participating in the process?

The following examples illustrate some potential barriers and strategies for addressing them:

Language: If you are trying to reach newcomers whose first language is not English, then it may be necessary to use cultural interpreters or facilitators who speak the language of the stakeholders.

Literacy level: Health providers frequently use language that is filled with acronyms and technical/medical terms. Use materials and language that is a good match for the literacy level of the stakeholders. It is best to pre-test materials to be sure.

Location/time: Find out the location, time of day and time commitment that will make it easiest for the stakeholders you want to reach to participate.

Social status: If you are trying to reach a “marginalized” population, such as the homeless, take steps to make sure they feel comfortable participating. Be conscious of “power differentials” that can affect participation. Get advice from organizations that work frequently with these groups, or partner with them to do the CE.

Other situations where stakeholder groups might benefit from a customized approach include:

Health service providers: Because of the nature of their work (highly scheduled, often difficult for them to get time off), it is often challenging to be able to engage them to participate in a “live” engagement process. Either try to design a process that is short and focussed, or consider other ways of soliciting their input (for example, electronically) that do not require them to participate at a meeting.

Internal stakeholders: Engagement processes that focus on stakeholders inside the same organization should be consistent with the values, processes and style of the organization. It is important to consider power differentials if supervisors and staff are participating in the same discussions, as staff may be reluctant to speak openly about some issues.

Health service organizations: Where a number of health service organizations are engaging together to discuss an issue, it is important to create an environment where all organizations feel comfortable participating. For example, facilitators should ensure that small organizations and volunteer-based groups have as much opportunity to participate as large organizations such as hospitals.